Endoscopic versus open component separation in complex abdominal wall reconstruction

Abstract 

Background

Open component separation has a high wound complication rate. Newer endoscopic approaches are described with no comparative trials.

Methods

A retrospective review (2005–2009) of patients undergoing open or endoscopic component separation was performed.

Results

Forty-four cases were identified (22 endoscopic; 22 open). All perioperative variables were the same except age (65 open vs 55 endoscopic; P < .05). Hospital length of stay was 11 days in the open group versus 8 days in the endoscopic group (P = .09). Wound complications were 52% in the open group versus 27% in the endoscopic group (P = .09). Wound-related interventions occurred in 45% of the open group and 33% of the endoscopic group. Hernia recurrences rates were similar (open, 32%; endoscopic, 27%; P = .99).

Conclusions

Open and endoscopic components separation have similar rates of recurrence. The endoscopic group had shorter lengths of stay and less major wound complications. The endoscopic approach may be the ideal technique for complex abdominal wall reconstruction.

Keywords: Component separation, Minimally invasive, Endoscopic, Ventral hernia, Contamination, Abdominal wall reconstruction